Chapter 43- Drugs Affecting Blood Pressure

Question 1

What is Captopril?

Answer 1

Angiotensin-Converting-Enzyme Inhibitor for the treatment of…

1. HTN
2. HF
3. Diabetic Nephropathy
4. Left Ventricular Dysfunction after an MI

Question 2

What are the actions of Captopril?

Answer 2

Blocks angiotensin-converting enzyme from converting angiotensin I -> AT II, decreasing BP and aldosterone production.

Leads to a small increase in serum K+ levels, along with Na+ and fluid loss.

Question 3

What are the adverse effects of captopril?

Answer 3

Cough
Tachycardia
MI 
pruritus
gastric irritation 
bone marrow suppression
(more on pg. 713)

Question 4

Contraindications for Captopril?

Answer 4

1. HF
2. Salt/Volume Depletion
3. Women of childbearing age need to start using candams.

ABSORPTION OF ORAL ACE INHIBITORS DECREASES WITH FOOD

Question 5

What is Losartan?

Answer 5

Angiotensin II - receptor blocker that is for the treatment of…

1. HTN alone or in combination therapy.
2. Diabetic nephropathy with an elevated serum creatinine and proteinuria in PT with type 2 diabetes and HTN.

Question 6

What are the actions of Losartan?

Answer 6

Selectively blocks the binding of AT-II to specific tissue receptors found in the vascular smooth muscle and adrenal glands.

Blocks the vasoconstriction and release of aldosterone associated with the renin-angiotensin-system.

Question 7

What are adverse effects of Losartan?

Answer 7

1. Symptoms of upper resp. tract infection
2. Back pain
3. hypotension
4. abdominal pain

Question 8

Contraindications of Losartan?

Answer 8

1. Hypovolemia

2. Women need to start using candams again.

Question 9

What is Diltiazem?

Answer 9

Calcium Channel Blocker for the treatment of…

1. HTN in the extended release form.

ACTIONS:
Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells, depressing the impulse and leading to slowed conduction, decreasing myocardial contractility, and dilation of arterioles, lowing BP and lowering myocardial oxygen consumption.

Question 10

Adverse effects of Diltiazem?

Answer 10

Peripheral Edema
Dizziness
AV block 
Bradycardia 
Flushing

Question 11

Contraindications of Diltiazem?

Answer 11

Heart block or sick sinus syndrome

CC BLOCKERS INTERACT WITH GRAPEFRUIT JUICE INCREASING CONCENTRATIONS TO TOXIC LEVELS

Question 12

What is Nitroprusside?

Answer 12

Vasodilator for the treatment of….

1. Severe HTN
2. Maintenance of controlled HTN during anesthesia
3. Acute HF

Reserved for hypertensive emergencies.

Question 13

Actions of Nitroprusside?

Answer 13

Acts directly on vascular smooth muscle to cause vasodilation and drop in BP, does not inhibit cardiovascular reflexes and tachycardia; renin release will occur.

Question 14

Adverse effects of Nitroprusside?

Answer 14

Cyanide Toxicity 
Retrosternal pressure
Diaphoresis
Palpatations
Apprehension 
(more on p.720)

Question 15

Contraindications of Nitroprusside?

Answer 15

1. Any condition exacerbated by a sudden fall in BP
2. Peripheral Vascular Disease
3. CAD
4. HF
5. Tachycardia